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Results of conservative treatment of partial tears of the anterior cruciate ligament

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Summary

The diagnosis of an acute partial tear of the anterior cruciate ligament was made in 56 patients who did not undergo surgical repair. After a period of up to 5 years, 39 returned for follow up evaluation. They were divided into three groups according to clinical analysis of the knee and the Lysholm-Gillquist score. Our aim was to determine their long term functional limitations. 56% had progressed to anterior cruciate ligament deficiency at the time of follow up. This came about not only after resuming sporting activities, but also occurred in those who were not so active. Our results suggests that a partial tear leaves an irreversible defect which may progress to a complete tear, especially in young athletes engaged in active sport.

Résumé

Chez 56 patients le diagnostic de rupture partielle du ligament croisé antérieur (LCA) a été confirmé par arthroscopie, mais n'a pas entraîné de traitement chirurgical. 39 de ces patients (70%) ont été revus après six ans. L'objectif était d'évaluer à long terme les séquelles de cette lésion dans la vie courante et les activités sportives. Après analyse de l'examen clinique du genou, les patients ont été classés en trois groupes, selon la cotation de Lysholm-Gillquist:

Groupe I (4 patients): perte totale de la fonction du LCA,

Groupe II (18 patients): diminution fonctionnelle du LCA,

Groupe III (17 patients): fonction clinique conservée.

56% des patients examinés ont donc évolué vers l'instabilité du genou. Cette évolution concerne non seulement l'activité sportive mais aussi l'utilisation du genou dans la vie courante. Même le groupe de patients ayant conservé une fonction clinique du LCA n'ont que 84 points sur la cotation de Lysholm-Gillquist. Ces constatations montrent que la rupture partielle du LCA constitue une lésion irréversible, comportant le risque d'évolution vers la rupture totale. La plastie ligamentaire est donc indiquée dans les ruptures partielles du LCA, en particulier chez les sujets jeunes et les sportifs professionnels.

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Correspondence to M. Lehnert.

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Lehnert, M., Eisenschenk, A. & Zellner, A. Results of conservative treatment of partial tears of the anterior cruciate ligament. International Orthopaedics 17, 219–223 (1993). https://doi.org/10.1007/BF00194182

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Keywords

  • Public Health
  • Anterior Cruciate Ligament
  • Conservative Treatment
  • Cruciate Ligament
  • Functional Limitation